Treatment with modified intravesical oxybutynin chloride for neurogenic bladder in children.
OBJECTIVE
We have previously reported that intravesical oxybutynin chloride with hydroxypropylcellulose (modified intravesical oxybutynin) is an effective therapeutic agent for patients with detrusor overactivity. In this study, we report on the efficacy, safety and side effects of modified intravesical oxybutynin administration in children with neurogenic bladder.


METHODS
Modified intravesical oxybutynin (1.25mg/5 mL, twice a day) was administered to four children (three males and one female) with neurogenic bladder (detrusor overactivity and/or low compliance bladder), who were previously unresponsive to or experienced intolerable side effects from oral medications. A cystometrogram was obtained before, 1 week after, and 1 year after the first intravesical instillation of modified oxybutynin. We also carefully observed anticholinergic side effects, occurrence of urinary tract infection and degree of incontinence during this treatment.


RESULTS
After 1 week, both cystometric bladder capacity and compliance were improved in all patients, and detrusor overactivity was undetectable in three of four patients. At 1 year, there was further improvement in bladder compliance in three patients, and detrusor overactivity was not observed in two patients. Significant improvement in the degree of incontinence was achieved. No systemic anticholinergic side effects were observed in any of the patients. One patient with vesicoureteral reflux discontinued the therapy after 2 months due to upper urinary tract infections.


CONCLUSIONS
Modified intravesical oxybutynin is an effective and relatively safe therapeutic option for children with neurogenic bladders.
Hayashi
Atsushi
A
Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan.
Saito
Motoaki
M
Okada
Shin-ichi
S
Hanada
Takuya
T
Watanabe
Takeshi
T
Satoh
Keisuke
K
Kanzaki
Susumu
S